US2006009780A1PendingUtilityA1

Percutaneous registration apparatus and method for use in computer-assisted surgical navigation

51
Individually held — no corporate assignee on recordPriority: Sep 24, 1997Filed: Aug 8, 2005Published: Jan 12, 2006
Est. expirySep 24, 2017(expired)· nominal 20-yr term from priority
Inventors:Kevin T. FoleyJohn B. ClaytonAnthony J. MelkentMichael C. Sherman
A61B 17/7083A61B 2090/3983A61B 2034/2055A61B 17/70A61B 2090/3945A61B 2017/00477A61B 34/10A61B 34/20A61B 2034/2072A61B 90/11A61B 2090/363A61B 17/7032
51
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Claims

Abstract

An apparatus and procedures for percutaneous placement of surgical implants and instruments such as, for example, screws, rods, wires and plates into various body parts using image guided surgery. An apparatus for use with a surgical navigation system, an attaching device rigidly connected to a body part, such as the spinous process of a vertebrae, with an identification superstructure rigidly but removably connected to the attaching device. This identification superstructure, for example, is a reference arc and fiducial array which accomplishes the function of identifying the location of the superstructure, and, therefore, the body part to which it is fixed, during imaging by CAT scan or MRI, and later during medical procedures.

Claims

exact text as granted — not AI-modified
1 . A method of positioning an implant in an anatomy, including a first implant portion and a second implant portion with a surgical navigation system, comprising: 
 positioning the first implant portion through an opening in a soft tissue of the anatomy;    tracking a position of the first implant portion;    interconnecting an implant inserter with the second implant portion;    determining a location of the second implant portion; and    moving the second implant portion relative to the first implant portion via determining a location of the second implant portion.    
     
     
         2 . The method of  claim 1 , wherein positioning a first implant portion through an opening in a soft tissue, moving the second implant portion relative to the first implant portion, or combinations thereof includes positioning the first implant portion, the second implant portion, or combinations thereof percutaneously.  
     
     
         3 . The method of  claim 2 , wherein tracking a position of the first implant portion includes; 
 interconnecting a tracking apparatus with the first implant portion; and    tracking the tracking apparatus interconnected to the first implant portion.    
     
     
         4 . The method of  claim 3 , further comprising: 
 determining a position of the portion of the first implant portion;    wherein moving the second implant portion relative to the first implant portion includes determining a location of a second implant portion relative to the first implant portion.    
     
     
         5 . The method of  claim 4 , further comprising: 
 displaying the determined position of the first implant portion and the position of the second implant portion.    
     
     
         6 . The method of  claim 1 , further comprising: 
 configuring the second implant portion based upon a tracked position of the first implant portion, a determined location of the second implant portion, or combinations thereof.    
     
     
         7 . The method of  claim 1 , further comprising: 
 interconnecting a reference frame with the anatomy.    
     
     
         8 . The method of  claim 7 , further comprising: 
 displaying a determined position of the second implant portion on a display relative to a registered image of the anatomy.    
     
     
         9 . The method of  claim 1 , further comprising: 
 interconnecting a tracking apparatus with the implant inserter; and    tracking the tracking apparatus.    
     
     
         10 . The method of  claim 1 , wherein determining a location of the second implant further includes tracking the tracking apparatus.  
     
     
         11 . The method of  claim 9 , wherein the tracking apparatus includes a sensor.  
     
     
         12 . The method of  claim 11 , further comprising: 
 selecting a sensor to include at least one of a light emitter, an infrared light emitter, an electromagnet, a magnet, a radiation emitter, or combinations thereof.    
     
     
         13 . The method of  claim 1 , further comprising: 
 imaging the anatomy while at least one of tracking the position of the first implant, tracking the tracking apparatus, determining a location of a portion of the second implant portion, or combinations thereof.    
     
     
         14 . The method of  claim 13 , wherein imaging the anatomy includes imaging the anatomy with an ultrasound system.  
     
     
         15 . The method of  claim 1 , further comprising: 
 positioning a third implant portion through an opening in a soft tissue; and    interconnecting the first implant portion and the third implant portion with the second implant portion by moving the second implant portion relative to the first implant portion and the third implant portion.    
     
     
         16 . The method of  claim 1 , wherein said first implant portion is a slot in a screw head; 
 wherein said second implant portion is a rod;    wherein moving the second implant portion includes aligning the rod with the slot.    
     
     
         17 . The method of  claim 16 , further comprising: 
 fixing the first implant portion to a vertebrae.    
     
     
         18 . The method of  claim 1 , wherein tracking a position includes tracking with an acoustic tracking system, optical tracking system, electromagnetic tracking system, micropulsed radar, or combinations thereof.  
     
     
         19 . A method of performing a spinal procedure in an anatomy with a surgical navigation system, comprising: 
 positioning a first screw implant in a vertebrae percutaneously through an opening in a soft tissue of the anatomy;    tracking a position of the first screw implant;    orientating the first screw implant in a selected orientation at least in part via tracking the position of the first screw implant;    interconnecting an implant inserter with a rod;    determining a position of a portion of the rod; and    moving the rod relative to the first screw implant via determining a location of the rod to interconnect the screw with rod.    
     
     
         20 . The method of  claim 19 , further comprising: 
 interconnecting a second tracking apparatus with the implant inserter.    
     
     
         21 . The method of  claim 19 , wherein orientating said first screw implant includes orientating a slot defined by the screw.  
     
     
         22 . The method of  claim 21 , wherein tracking a position of the first screw implant includes interconnecting a screw tracking apparatus with the first screw implant.  
     
     
         23 . The method of  claim 22 , wherein interconnecting the screw tracking apparatus includes selecting a sensor.  
     
     
         24 . The method of  claim 23 , wherein selecting the sensor includes selecting a light emitting diode, a light reflector, an infrared emitter, a magnet, an electromagnet, an acoustic emitter, an infrared reflector, or combinations thereof.  
     
     
         25 . The method of  claim 22 , wherein interconnecting the screw tracking apparatus with the first screw implant includes positioning the screw tracking apparatus percutaneously.  
     
     
         26 . The method of  claim 22 , wherein tracking the tracking apparatus includes at least triangulating a position of the tracking apparatus with the surgical navigational system.  
     
     
         27 . The method of  claim 26 , wherein the surgical navigation system includes an acoustic tracking system, or electromagnetic tracking system, an optical tracking system, a micropulsed radar, or combinations thereof.  
     
     
         28 . The method of  claim 19 , wherein orientating the first screw implant includes selecting an orientation of a head of the screw relative to a portion of the anatomy.  
     
     
         29 . The method of  claim 21 , wherein orientating the first screw implant includes orientating the slot relative to the anatomy.  
     
     
         30 . The method of  claim 29 , further comprising: 
 positioning a second screw implant in a vertebrae percutaneously; and    orientating the second screw implant;    wherein orientating the second screw implant includes orientating second screw implant relative to the first screw implant.    
     
     
         31 . The method of  claim 30 , wherein moving the rod relative to the first screw implant includes moving the rod relative to both the first screw implant and the second screw implant.  
     
     
         32 . The method of  claim 31 , further comprising: 
 manipulating the rod to achieve an interconnection of the first screw implant and the second screw implant.    
     
     
         33 . The method of  claim 19 , wherein interconnecting the implant inserter with the rod includes interconnecting the implant inserter near a first end of the rod, a second end of the rod, a portion intermediate between the first end and the second end, or combinations thereof.  
     
     
         34 . The method of  claim 19 , wherein interconnecting an implant inserter with a rod includes rigidly interconnecting an implant inserter with the rod.  
     
     
         35 . The method of  claim 34 , further comprising: 
 interconnecting a tracking apparatus with the implant inserter that includes rigidly interconnecting the tracking apparatus with the implant inserter.    
     
     
         36 . The method of  claim 19 , wherein interconnecting an implant inserter with a rod includes releasably interconnecting the implant inserter with the rod.  
     
     
         37 . The method of  claim 19 , further comprising: 
 interconnecting a tracking apparatus with the implant inserter that includes positioning an emitter on the tracking apparatus.    
     
     
         38 . The method of  claim 37 , wherein interconnecting a sensor with the tracking apparatus includes selecting at least one of a light emitting a diode, a light reflecting portion, an infrared light emitting portion, an infrared light reflecting portion, an acoustic emitter, an electromagnet, a magnet, or combinations thereof.  
     
     
         39 . The method of  claim 19 , further comprising: 
 imaging a portion of the anatomy.    
     
     
         40 . The method of  claim 39 , wherein imaging a portion of the anatomy includes obtaining an MRI scan, a CT scan, an x-ray image, an ultrasound image, or combinations thereof.  
     
     
         41 . The method of  claim 19 , further comprising: 
 displaying an image of the anatomy; and    displaying a position of the portion of the screw on the display relative to the image of the anatomy, and displaying a determined position of the rod relative to the image of the anatomy.    
     
     
         42 . The method of  claim 41 , wherein moving the rod relative to the screw includes displaying on the display the portion of the rod relative to the position of the head of the screw.  
     
     
         43 . The method of  claim 42 , further comprising: 
 manipulating the rod to achieve a selected interconnection of the rod and the screw implant.    
     
     
         44 . The method of  claim 43 , wherein manipulating the rod includes bending the rod.  
     
     
         45 . The method of  claim 44 , further comprising: 
 positioning a second screw implant in a vertebrae percutaneously; and    moving the rod relative to the screw implant and the second screw implant.    
     
     
         46 . The method of  claim 19 , wherein moving the rod relative to the screw includes moving the rod substantially percutaneously.  
     
     
         47 . The method of  claim 46 , wherein moving the rod substantially percutaneously includes inserting the rod through a substantially single opening in a soft tissue of the anatomy and moving the rod based upon a tracked position of the rod.  
     
     
         48 . The method of  claim 47 , wherein tracking a position of the portion of the screw and determining a position of a portion of the rod is substantially percutaneous.  
     
     
         49 . The method of  claim 19 , wherein tracking the position of the first screw implant includes tracking a position of a slot defined by the screw.  
     
     
         50 . The method of  claim 49 , wherein moving the rod relative to the first screw implant includes moving the rod percutaneously through the slot.  
     
     
         51 . The method of  claim 50 , further comprising: 
 positioning a second screw implant in a vertebrae percutaneously through an opening in a soft tissue of the anatomy;    tracking a position of the second screw implant; and    orientating the second screw implant in a selected orientation at least in part via tracking the position of the second screw implant.    
     
     
         52 . The method of  claim 51 , wherein orientating the second screw implant includes aligning a second slot defined by the second screw implant with a first slot defined by the first screw implant at least in part by tracking the position of the first screw implant, tracking the position of the first screw implant, or combinations thereof; 
 wherein moving the rod includes moving the rod through the first slot and the second slot;    
     
     
         53 . The method of  claim 52 , further comprising: 
 fixing the rod to the first screw implant and the second screw implant.

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